The study on the causes of resistance to antihypertensive therapy in patients with chronic glomerulonephritis


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Aim. To identify risk factors for resistant arterial hypertension (Rah) in patients with chronic glomerulonephritis (CGN). Material and methods. Analysis of the data of 421 patients included clinical and laboratory findings, details of therapeutic regimen (drug class, dosage of antihypertensive drugs, accompanying conservative treatment). Discriminative analysis using semi-automatic scoring was conducted. Results. Several indicators having the greatest predictive value were identified. They included the use of dihydropyridine calcium channel blockers (DHP-CCB) and beta-blockers, increased triglyceride level, clinical variant of CGN, decreased GFR CKD-ЕРІ, the stage of CKD and blood creatinine concentration. The final scoring model comprised the data of drug scheme: DHP-CCB, beta-blockers, loop and thiazide diuretics. The results showed the crucial importance of drug therapy in rah. The high prevalence of the so-called pseudo resistant hypertension in our sample implies the importance of the individualized selection of therapy in CGN. Conclusions. Currently DHP-CCB and beta-blockers are undervalued drugs in terms of antihypertensive therapy in CGN patients with rah. Our work shows the potential effectiveness of these medications. Other criteria, such as the stage of CKD, creatinine level, and a new prognostic factor - the level of triglycerides - were confirmed to be of high value in the prognosis for rah.

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Sobre autores

K. Mil'chakov

Email: MKS13.09@YA.ru

V. Fomin

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